Healthcare Provider Details

I. General information

NPI: 1689272361
Provider Name (Legal Business Name): CAROLYN ARLIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7332 HIGHWAY 19
DEVILS LAKE ND
58301-8835
US

IV. Provider business mailing address

2528 123RD AVE NE
ANETA ND
58212-9245
US

V. Phone/Fax

Practice location:
  • Phone: 701-393-4461
  • Fax:
Mailing address:
  • Phone: 701-230-5120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: